Antegrade Versus Retrograde Facial Nerve Dissection in Benign Parotid Surgery: A Systematic Review and Meta-Analysis.
meta_analysis · Level I
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- Record sourced from PubMed, PMID 42331725.
- Also identified by DOI 10.1002/hed.70371.
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Abstract
Parotidectomy for benign tumors requires meticulous facial nerve preservation, yet the optimal dissection technique between anterograde dissection (AD) and retrograde dissection (RD) remains uncertain, prompting this updated meta-analysis comparing their outcomes. Twenty-one studies (1632 patients) were included. Outcomes comprised operative parameters, postoperative complications, and facial nerve recovery. Pooled effects were estimated using odds ratios (ORs) and mean differences with 95% confidence intervals (CIs). RD significantly reduced transient facial nerve palsy versus AD (OR, 0.73; 95% CI, 0.54-0.98), with no difference in permanent palsy. Recovery was similar at 1, 6, and 12 months, although AD showed faster recovery at 3 months. Other complications were comparable. RD was associated with shorter operative time, less blood loss, and smaller resected tissue volume. Subgroup analysis indicated reduced transient palsy mainly in superficial parotidectomy. RD offers advantages over AD, particularly in superficial parotidectomy, though further randomized trials are warranted.